The Journal of neuropsychiatry and clinical neurosciences
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J Neuropsychiatry Clin Neurosci · Jan 2003
Biography Historical ArticleNeurodegenerative disorders: George Huntington's description of hereditary chorea.
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Déjà vu experiences are common in normal subjects. In addition, they are established symptoms of temporal lobe seizures. The author argues that the phenomenon is the result of faulty and isolated activity of a recognition memory system that consists of the parahippocampal gyrus and its neocortical connections. ⋯ The result is that a momentary perceived scene is given the characteristics of familiarity that normally accompany a conscious recollection. The normal functioning of other brain structures involved in memory retrieval--the prefrontal cortex and the hippocampus proper--leads to the perplexing phenomenological quality of déjà vu. The hypothesis accounts for many characteristics of déjà vu in healthy subjects and is well fitting with experimental findings in patients with epilepsy.
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J Neuropsychiatry Clin Neurosci · Jan 2001
Comparative StudyValidation of the Delirium Rating Scale-revised-98: comparison with the delirium rating scale and the cognitive test for delirium.
The DRS-R-98, a 16-item clinician-rated scale with 13 severity items and 3 diagnostic items, was validated against the Cognitive Test for Delirium (CTD), Clinical Global Impression scale (CGI), and Delirium Rating Scale (DRS) among five diagnostic groups (N=68): delirium, dementia, depression, schizophrenia, and other. Mean and median DRS-R-98 scores significantly (P<0.001) distinguished delirium from each other group. DRS-R-98 total scores correlated highly with DRS, CTD, and CGI scores. ⋯ Cutoff scores for delirium are recommended based on ROC analyses (sensitivity and specificity ranges: total, 91%-100% and 85%-100%; severity, 86%-100% and 77%-93%, respectively, depending on the cutoffs or comparison groups chosen). The DRS-R-98 is a valid measure of delirium severity over a broad range of symptoms and is a useful diagnostic and assessment tool. The DRS-R-98 is ideal for longitudinal studies.
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J Neuropsychiatry Clin Neurosci · Jan 2001
Prefrontal cortex modulation of mood and emotionally induced facial expressions: a transcranial magnetic stimulation study.
Repetitive transcranial magnetic stimulation (rTMS) can serve as a tool to experimentally test hypotheses of prefrontal cortex (PFC) modulation of emotions. The present study used rTMS to test whether self-rated mood and emotionally induced facial expressions are hemispherically lateralized depending on their valence, as indicated by previous studies. ⋯ Facial expression analysis revealed lateralized changes of facial expressions after rTMS, whereas changes of subjective mood ratings did not show a hemispheric lateralization. On the basis of this study, the authors propose to combine rTMS and facial expression analysis for further studies of the cortical modulation of emotions in humans.
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J Neuropsychiatry Clin Neurosci · Jan 2000
Relationship between symptoms and motoric subtype of delirium.
For 46 patients with delirium who were consecutive referrals to a consultation-liaison psychiatry service, the authors describe the relationships between symptoms, as rated on the Delirium Rating Scale, and delirium motoric subtypes, as defined by Liptzin and Levkoff's criteria. Most cases were of the mixed subtype (46%), 24% were hypoactive, and 30% were hyperactive. ⋯ The results suggest that delirium presents as motoric subtypes that differ according to symptom profile and severity of delirium. These subtypes may differ in their underlying pathophysiologies, responsiveness to therapeutic interventions, and outcome.